When asked whether the lingering workforce shortages are affecting access to care, Rhode Island’s health care leaders had a clear answer.
“Yes, period, end of sentence. It is brutal,” said Lifespan Corp. CEO and President John Fernandez.
As the leader of Rhode Island’s largest health system, Fernandez explained that improving patients’ access to care is one of his top priorities, but that can’t be done without enough staff.
“If you can’t get in to see a doctor, then the quality of care is sort of hard to measure,” Fernandez said at Providence Business News’ Fall 2023 Health Care Summit at the Crowne Plaza Providence-Warwick on Oct. 25.
Fernandez was joined by fellow industry leaders for one of the summit’s two panel discussions focused on the current state of health care in Rhode Island, as well as ongoing efforts to improve access, affordability and challenges related to recruitment and retention.
Also on the panel: Dr. Michael Wagner, CEO and president of Care New England Health System, the state’s second-largest hospital group. Together, Lifespan and Care New England hospitals employ more than 20,000 in Rhode Island.
Wagner said staffing levels at CNE have started to bounce back since the COVID-19-era “Great Resignation,” but boosting the workforce and improving equity in the workplace is important for preventing burnout.
“We’re really trying to understand people: where they’re coming from and what they want to create a sense of belonging. The issues of DEI [diversity, equity and inclusion] are another source of burnout in the workplace, so addressing those issues and really creating a belonging environment,” Wagner said. “One of the fundamental issues is making sure we have a sufficient number of people … so that we actually give people time off, allow them to recharge and then allow them that space to really enjoy the work that they do.”
Also, improving the workplace environment could attract workers to Rhode Island, which would then help health systems remain competitive within New England, Wagner said, noting that there are five top-100 health care systems surrounding the Ocean State.
“We as a state need to recognize that we need to be playing at that level in order for us to be able to recruit talent and to be able to provide the services within the state [that] Rhode Islanders want,” Wagner said.
Fernandez also emphasized the importance of compensating mental health professionals, as demand for behavioral health care services has remained at “crisis levels” amid a lag in workforce development in Rhode Island.
“We have to accept the reality that we need to pay our mental health providers a good wage,” Fernandez said. “There are not enough of them. If you want to talk about an access problem, the mental health area is it.”
Panelists agreed this is especially important, as patients seeking behavioral health care have been increasingly relying on already strained emergency rooms.
Dr. Raj Hazarika, chief medical officer for commercial products at Point32Health Inc., said that some technological innovations such as telehealth could help improve access to care, as there is a limited availability of providers.
“Telemedicine is one of the silver linings from the pandemic. We absolutely want that to continue because those visits address issues – they prevent folks from getting in crisis situations, ending up in a distressed state, ending up in the emergency room or worse,” Hazarika said. “So, we want to support telemedicine in the area of behavioral health and support telemedicine in general because we believe this addresses a big issue of accessibility.”
Children are another patient population feeling the effects of workforce shortages, said Dr. Scott Rivkees, interim chair of health services, policy and practice and professor of the practice of health services, policy and practice at Brown University’s School of Public Health.
“There are many pediatric practices in the state, which are closed to new children other than babies and the workforce issue really means a major, major problem with that,” Rivkees said. “So unless we increase the number of physicians, nurse practitioners, physician’s assistants, nursing staff to try to help support health care, it’s always going to be a bottleneck.”
While government funding is helping somewhat, both Wagner and Fernandez say they are partnering with universities and colleges in Rhode Island to boost the state’s supply of health care workers.
“I think we need to do everything we can to encourage people to get into the field whether you’re a radiologist, MRI tech or nurse, “Fernandez said. “[Health care] is a great place to work.”
Wagner also pointed out that a notable effort between Rhode Island’s higher education and health care institutions to develop the state’s workforce is known as “The Rhode Ahead.”
The program is a public-private partnership that was established in spring 2022 and is spearheaded by the R.I. Executive Office of Health and Human Services, R.I. Department of Labor and Training and the R.I. Office of the Postsecondary Commissioner.
“So, the Rhode Ahead is a collaboration of state colleges [and] health care organizations [that] have come together now two years in a row to talk about ways that we could focus on workforce development,” Wagner said. “I think the concept of us creating pathways in health care from a workforce development perspective is something we all have to participate in – colleges, health care organizations and government across the board.”